That’s why the APA recently issued new guidelines on psychological practice with boys and men — to guide mental health professionals in helping men live healthier lives, said one of the guidelines’ co-authors, Matt Englar-Carlson, a professor of counselling at California State University, Fullerton.

“There’s a lot of men out there who suffer, who go through a lot of difficulty and aren’t getting the support they need,” he said.

The guidelines, which are aimed at psychologists and other mental health practitioners and join existing guidelines on treating girls and women, include things like encouraging men to have healthy family relationships, being sensitive to issues of race, reducing aggression in their clients and getting men to take on more healthy behaviours.

They also take a hard look at masculinity and how it shapes men’s lives, relationships and activities.

As defined in the guidelines, “masculinity ideology” is a set of rules that dictate what it is to be a man. In very traditional views, this can include things like being strong, withholding emotion and taking care of things by yourself, said Englar-Carlson.

“In many ways, when you look at these (rules) in terms of what it means to be a man, in some ways, they can be quite helpful, in other places they can be hurtful,” he said.

“The notion that men should be independent, that can be really helpful in certain circumstances when you need to do things on your own, when you need to get things done, when you need to step up and be a leader. But a lot of men also learn that being independent means you can’t ask for help.”

This can cause problems if someone really needs help — say, due to severe depression — and decides not to get it, he said.

“Across the world, in most societies, men are four times more likely to commit suicide than women,” said Englar-Carlson.

“I don’t think that’s OK. I think we should be looking at that and saying that’s an epidemic.”

Asking for help

Rick Goodwin has seen the negative effects first-hand.

Goodwin is the founder of Men & Healing, an Ottawa counselling service that focuses on men and has worked in the field for decades. This week, he said, he started a new group for men who had experienced childhood physical or sexual abuse.

“The average age for men coming into the trauma program is 45,” said Goodwin. “The average age of these guys being sexually abused is between 9 and 10.”

“Somewhere, we’ve got to make an account of why do men take so long to engage in the healing work and the recovery work?”

While he thinks that men don’t have the same access to this kind of targeted counselling as women, he doesn’t believe it’s the only reason they wait.

“We can’t truly account for that without going back to this male code that the article refers to and how that prevents men from asking for help, prevents men from saying that they’ve been harmed,” he explained.

“I don’t like the term ‘toxic masculinity.’ It sounds a lot like name-calling,” he said. Self-sacrifice, for example, can be a positive quality, Goodwin thinks.

“I think what the guidelines are saying is stifling your emotions, not asking for help, seeking status, acting in ways that are aggressive, these are not good for anybody,” said Giese. “And the guideline is saying the traditional definition of masculinity actually really values these things that we know to not be good for us.”

For Englar-Carlson, it’s not about attacking masculinity, it’s about improving health.

“I like guys who are strong and are tough and provide. But I also prefer the guys around me healthy and alive.”

He hopes that the APA’s guidelines are used to improve psychologists’ ability to work with men — particularly since so many practitioners in the area are women.

“We’re not necessarily saying that it’s only men who have to change, we’re also saying the field has to change,” he said. “How we engage, the questions that we ask, how we assess for things like depression and suicidality and other aspects of their lives.”

If you or someone you know is in crisis and needs help, resources are available. In case of an emergency, please call 911. For mental health programs and services around Canada, pleaserefer to the list here.